Study, eat, sleep, repeat: Have you got what it takes to study medicine?

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A typical day for third-year medical student Katie Shepard starts at 5.30am and ends after midnight. After eight hours on campus, there are a few tutoring sessions to pay the rent, topped off by more study after dinner.

Friends or family? They have to take a back seat.

Katie Shepherd, 20, from Busselton in WA’s South West, is a third-year medical student at Curtin University.

Medical students are guaranteed a job upon completion of their degree amid a national doctor shortage, but the path to becoming a doctor is difficult, highly competitive and expensive.

Only about 4 per cent of the students hoping for one of about 300 spots on offer at three universities – the University of Western Australia, Curtin University, and the University of Notre Dame – are successful.

The selection processes are long and arduous. Besides an Australian Tertiary Admission Rank of 95-98, undergraduate applicants have to sit the University Clinical Aptitude Test, which assesses their decisionmaking, verbal, quantitative and abstract reasoning, and situational judgement.

For postgraduate students, what counts is a combination of the Grade Point Average of their undergraduate degree and their GAMSAT score (the graduate equivalent of the UCAT, a six-hour test that requires students to read and evaluate a huge quantity of information in a limited time).

Curtin and Notre Dame also require a situational judgement test called CASPer that measures applicants’ traits such as professionalism, ethics, communication and empathy.

If students score well enough, they will be invited to a structured interview where they are put through several short assessments – “stations” – usually lasting 10 minutes or less. Before each one, they will be presented with a scenario and given some time to prepare an answer.

Hayden Jackson-Cross, 32, a first-year junior doctor with an MD degree from Notre Dame University, had already completed a four-year physiotherapy degree when he set his sights on medicine. He said the process was gruelling.

“I remember sitting waiting for my lift and just being so anxious about what to expect,” he said.

“Once we got there, it took a good hour to an hour and a half for everyone to get herded in. I just remember it being this sea of anxiety and … people just looked terrified.”

Hayden Jackson-Cross’ son Hugo was born in the second year of his medical degree.

Third-year Notre Dame medical student Vicky Ferdinands, 32, already had a 12-year career in nursing when she finally got a placement on her third attempt.

“I would say that probably the hardest part so far was actually just getting in, that was very difficult,” she says.

“I’ve wanted to do medicine my entire life, but I think when I was a lot younger, I was probably a bit naive and didn’t realise just how important things were in an undergrad degree. So I needed to get my grade point average up.”

To increase that score, Ferdinands undertook two postgraduate courses on top of her nursing degree.

The complex and extensive testing matrix for admission to medicine is designed to select people with the right aptitude, according to Australian Medical Association WA president Michael Page.

“Long gone are the days when extremely high marks in Year 12 were both necessary and entirely sufficient to gain access to a place in medical school,” Dr Page said.

“Of course, academic performance is still important. But aptitude has been much more comprehensively assessed for a number of years through medicine-specific entry examinations and formal interviews designed to assess not only scientific knowledge but also written and verbal communication skills, problem-solving, empathy and maturity.”

The national head of medicine at Notre Dame, Professor Gervase Chaney, said resilience, compassion, humanity and humility were critical attributes for being a good doctor.

Curtin University’s Director of Medical Program, Dr Heidi Waldron, said she also looked for fantastic communication skills and empathy.

Vicky Ferdinands said she was “naive” when she first set her sights on medicine, despite a 12-year career as a nurse.

She said the interview stage of Curtin’s application process was designed to find people who could draw on life experiences and work well in teams.

Despite the three degrees under her belt, Ferdinands said the amount of study required in medicine could not compare to anything she had ever done before.

“In undergrad world, everything’s pretty stock standard. You’ve got an obvious unit structure … if you do these assignments in this very short amount of time you will pass this and gain this qualification,” she said.

“But medicine, I would not say it’s like that. The whole medical culture, even as a profession, is very much one of ongoing learning.

“Right now, just before exams, I’m basically on placement or I’m studying, if I’m not sleeping, eating or driving somewhere.”

She said work-life balance was challenging and burnout a reality.

“You’ve basically got 100 people who were some of the best students in the country in a concentrated group. So, they’re almost all type A personalities that are all high achievers,” she said.

Hayden Jackson-Cross said he had seen a lot of mental health turmoil among his fellow students, and he had had to get “comfortable being uncomfortable”.

“The model of teaching at Notre Dame, which I found really fantastic, was their problem-based learning model. And the way they designed it was that essentially from week one, you would be given real cases that you would then apply what you’re learning through that time.

“Which meant that early on, you really had no idea for most of the case, you hadn’t learned about many of the body systems and other things that were into playing the case. And you felt like you were behind the eight-ball all the time.”

Managing workloads is something Curtin’s Dr Heidi Waldron considers a vital skill.

“We encourage our students to live balanced lives so they can truly be part of the community and develop a rich understanding of the diverse fabric of our society,” she said.

But growing cost-of-living pressures had increased the “already substantial” mental and psychological stress of students over the past years, according to Notre Dame’s Professor Chaney.

He said many students were working longer hours in part-time jobs just to get by.

While Ferdinands was able to reduce her student debt significantly while she worked in nursing, she still needs to pay off about $50,000.

It’s significantly more for Jackson-Cross, whose degrees have added up to $100,000, which he says is standard within his cohort.

Upon completion of their medical degree, graduates spend 12 months interning in accredited tertiary hospitals with a starting wage of about $80,000 annually, with some higher rates for those working in rural areas.

“I think the earning potential for doctors, whilst it can be high, is probably lower than what most people would picture,” he said.

But one thing graduates won’t have to worry about is getting a job.

The AMA’s Dr Page says nearly every medical graduate secures a hospital internship, and wages do go up quickly, especially with a specialisation. But specialisation could mean up to 10 years of additional study.

Jackson-Cross describes studying medicine as a privilege. “The things that I find the most rewarding aren’t necessarily the medicine side of it. It’s just being able to sit down and talk with someone, someone who feels like they haven’t been heard for a long time,” he said.

“People are in very vulnerable situations. Just being able to connect with them on some level and let them know that the health system hasn’t forgotten about them and that there are people who do want to genuinely help them.”

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